What are the laws governing health insurance coverage?

In California, health insurance coverage is governed by several laws. The most important is the California Insurance Code, which outlines the duties and obligations of insurers and insureds, sets the terms and conditions of insurance policies, and establishes rules for filing and resolving disputes between insurers and insureds. Additionally, the California Health and Safety Code sets forth requirements for health insurance policies and acts as a supplement to the California Insurance Code. The California Department of Insurance manages and oversees the insurance industry in California, including health insurance. Under this department, the California Health Benefit Exchange (HBEX) operates and was established as a part of the Affordable Care Act. HBEX provides individuals and small businesses with access to affordable health insurance plans and provides subsidies to help with health insurance costs. The California Department of Managed Health Care (DMHC) regulates health care service plans, including health maintenance organizations (HMOs) and other managed care plans, as well as certain Assoicates. Under DMHC, the Access for Infants and Mothers program (AIM) provides comprehensive health care services for low-income pregnant women and infants. Additionally, the Health Care Coverage Initiative Act requires health plans to cover certain services and treatments, such as mental health, substance use disorder services, cancer screenings, preventive services, and HIV/AIDS treatment. Finally, the California Mental Health Parity Act requires health insurers to treat mental health and substance use disorder treatment the same as medical and surgical benefits. In summary, the laws governing health insurance coverage in California are designed to protect consumers, provide access to affordable health care, and promote the health of individuals.

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What are the laws governing health insurance coverage?

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